The University of Oklahoma Health Sciences Center proposes to partner with the CDC and other institutions in a collaborative project to implement the continuation of a directive within the Children's Health Act of 2000 to develop and scientifically evaluate interventions for children affected by Fetal Alcohol Syndrome Disorders (FASD) and their families. The primary objective of this proposal is to translate a promising scientifically evaluated intervention, Parent-Child Interaction Therapy (PCIT) for children with FASD, to community settings. PCIT is designed to reduce behavior problems common in this population as well as to reduce parenting stress. The specific aim of the project is to disseminate PCIT to four community mental health settings, including one tribal setting in an effort to bridge the transition between research-based development of interventions and community implementation of these interventions. Following a community service assessment to ensure stakeholder and partner involvement and outline ways to increase recruitment and retention, the training of the intervention therapists will begin. Specifically, the intervention will be PCIT, a 14-week (on average) intervention, coupled with FASD education, designed to increase caregiver understanding of the problem, and Motivational Enhancement, designed to increase retention of families involved in the intervention program. Although PCIT is an empirically based treatment, little is known about the uptake of the model in community settings and the intensity of supervision necessary for fidelity to the model as well as successful outcome for the families enrolled. Therefore, not only will this project seek to implement PCIT with children with FASD into community settings, but it will also endeavor to evaluate which of three approaches to training will result in the most effective and cost-efficient outcome. Ongoing feedback from community sites as well as from community partners will allow for necessary adaptations. A model for training trainers for further dissemination as well as plans for sustainability will also be incorporated into the proposed project. FASD with its resulting problems is a significant public health issue with the Institute of Medicine (1996) citing alcohol use during pregnancy as producing the most serious effect in the brain of the developing fetus of all substances of abuse. By designing and implementing a community-based approach to FASD, both the community and the families directly impacted can benefit. [unreadable] [unreadable]